The Contextual Effect of Place of Birth Delivery and Biopsychosocial Determinants on Postpartum Depression: A Multilevel Evidence from Yogyakarta

Background: Postpartum depression is a condition that affects 20% women in the first four weeks of the puerperium. Postpartum depression can be affected by biological, psychological, socio-cultural, and economic factors. This study aimed to analyze biopsychosocial factors affecting postpartum depression in Sleman, Yogyakarta.Subjects and Method: This was a cross-sectional study. This study was conducted at 25 delivery places in Sleman, Yogyakarta, in August-September 2019. A sample of 200 postpartum mothers was selected by multistage random sampling. The dependent variable was postpartum depression. The independent variables were traditional treatment, age, education, income, parity, pregnancy status, type of delivery, complication, marital satisfaction, and contextual delivery place. The data were collected by questionnaire and analyzed by a multilevel multiple logistic regression.Results: The risk of postpartum depression increased with delivery with intervention (b= 3.30; 95% CI= 1.57 to 5.02; p<0.001), delivery with complication (b=3.77; 95% CI= 2.25 to 5.28; p<0.001), and age ≥35 years (b=0.93; 95% CI=-0.20 to 2.07; p=0.109). The risk of postpartum depression decreased with traditional treatment (b= -1.33; 95% CI= -2.51 to -0.15; p= 0.027), education ≥Senior high school (b=-1.98; 95% CI= -3.59 to -0.38; p=0.015), family income ≥Rp 1,701,000 (b= -3.55; 95% CI= -5.08 to -2.02; p<0.001), multiparous (b= -1.25; 95% CI= -2.45 to -0.04; p=0.041), intended pregnancy status (b= -3.11; 95% CI= -4.96 to -1.25; p= 0.001), and happy marital satisfaction (b= -1.18; 95% CI= -2.30 to -0.05; p=  0.039). There was strong contextual effect of delivery place on postpartum depression with intra-class correlation (ICC)= 31.6%.Conclusion: The risk of postpartum depression increases with delivery with intervention, delivery with complication, and age ≥35 years. The risk of postpartum depression decreases with traditional treatment, education ≥Senior high school, family income ≥Rp 1,701,000, multiparous, intended pregnancy status, and happy marital satisfaction. There is strong contextual effect of delivery place on postpartum depression.Keywords: Postpartum depression, determinant, delivery placeCorrespondence: Selvia Febrianti. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: [email protected]. Mobile: 0811593921Journal of Maternal and Child Health (2020), 5(1): 88-99https://doi.org/10.26911/thejmch.2020.05.01.1

Path Analysis on the Effects of Peer Support and Sanitation Facilities on Personal Hygiene among Female Student having Menstruation in Sragen Central Java

Background: Poor personal hygiene during menstruation causes the risk of Reproductive Tract Infection (RTI) in adolescent. It threatens women's health. Personal hygiene is affected by attitude, peer support, and the availability of personal hygiene facilities. This study aims to analyze the determinant of personal hygiene in adolescents during menstruation in Sragen Regency, Central Java.Subjects and Method: This study was an analytic observational study with a cross sectional design. The study was conducted in June 2019. A sample of 200 study subjects was selected for this study by simple random sampling. The dependent variable was personal hygiene. The inde­pendent variables were attitude, peer support, and the availability of personal hygiene facilities. The study was collected by questionnaire and analyzed by path analysis.Results: Personal hygiene was directly and positively affected by positive attitude (b=1.38; 95% CI=0.78 to 1.98; p<0.001). Personal hygiene was indirectly affected by strong peer support and the availability of good personal hygiene facility.Conclussion: Personal hygiene is directly and positively affected by positive attitude. Personal hygiene is indirectly affected by strong peer support and the availability of good personal hygiene facility.Keywords: personal hygiene, attitude, peer support, personal hygiene facilitiesCorrespondence:Kunaryanti. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: [email protected]. Mobile: +6285700900029.Journal of Health Promotion and Behavior (2019), 4(3): 170-177https://doi.org/10.26911/thejhpb.2019.04.03.02

Biopsychosocial Factors Associated with Preterm Birth at Dr. Moewardi Hospital, Surakarta, Central Java

Background: Preterm birth has been defined asgestational age of birth between 28 and 37 weeks. Prematurity is a major public health issue as studies have shown it increases the risk of mortality and morbidity of the newborns. The purpose of this study was to examine biopsychosocial factors associated with preterm birth.Subjects and Method: This was an analytic observational with a case control design. The study was carried out at Dr. Moewardi Hospital, Surakarta, Central Java, from April to May 2018. A total sample of 200 of the newborn infants was selected for this study by fixed disease sampling, composing of 100 preterm newborns and 100 term newborns. The dependent variable was prematurity. The independent variables were maternal age, nutritional status, parity, ambient smoke exposure, maternal education, family income, and family support. The data on prematurity was obtained from medical record. The other variables were measured by a set of questionnaire. The data were analyzed by path analysis.Results: Preterm birth was positively associated with maternal age <20 or ?35 years (b= 1.58; CI 95%= 0.65 to 2.50; p<0.001), ambient smoke exposure (b= 1.42; CI 95%= 0.41 to 2.44; p=0.006), and parity (b= 1.77; CI 95%= 0.87 to 2.67; p<0.001). Preterm birth was negatively associated with good maternal nutritional status (b= 2.00; CI 95%= 2.92 to 1.08; p<0.001). Good maternal nutritional status was positively associated with strong family support (b= 0.93; CI 95%= 0.24 to 1.61; p=0.008), high family income (b= 2.26; CI 95%= 1.57 to 2.95; p<0.001), and high maternal education (b= 2.45; CI 95%= 1.76 to 3.17; p<0.001).Conclusion: Preterm birth is positively associated with maternal age <20 or ?35 years, ambient smoke exposure, and parity, but negatively associated with good maternal nutritional status.Keywords: preterm birth, biopsychosocial factors, path analysisCorrespondence:Harrys Bachtiar. Masters Program in Public Health, Universitas Sebelas Maret, Surakarta, Jl. Ir. Sutami No. 36 A, 57126, Surakarta, Central Java. Email: [email protected]. Mobile: +6285257311700.Journal of maternal and child health (2018), 3(2): 138-145https://doi.org/10.26911/thejmch.2018.03.02.0

Contextual Effect of Community Health Service on the Use of Triple Elimination Service

Background: Triple elimination is the elimination of transmission of HIV, syphilis, and hepatitis B from mother to child. The Prevention of Mother to Child Transmission (PMTCT) program is a comprehensive activity. The basic condition of the case is carried out because of the importance of health promotion and early detection in strategies for managing HIV, Syphilis, and Hepatitis B infections. This study aimed to analyzecontextual effect of community health service on the use of triple elimination service in pregnant women.Subjects and Method: This was a cross sectional study conducted at 25 community health centers in Sragen Regency, Central Java, from June to July 2019. A sample of 200 pregnant women was selected by stratified random sampling. The dependent variable was the use of triple elimi­nation. The independent variables were age, perceived susceptibility, perceived seriousness, cues to action, attitude, motivation, occupation, income, and distance to health service. The data were collected by a set of questionnaire and analyzed by multilevel multiple logistic regression.Results: The use of triple elimination increased with age ≥35 years (b=1.29; 95% CI=0.37 to 2.21; p=0.006), working outside the home (b=1.20; 95%CI=0.17 to 2.23; p=0.012), income by ≥Rp 1,600,000 (b=1.52; 95% CI=0.54 to 2.50; p=0.002), perceived susceptibility (b=1.46; 95% CI=0.53 to 2.38; p=0.002), perceived seriousness (b=1.53; 95% CI=0.55 to 2.50; p=0.002), cues to action (b=1.30; 95% CI=0.30 to 2.30; p=0.010), attitude (b=1.10; 95% CI=0.02 to 2.18; p=0.046), and strong motivation (b=1.68; 95% CI=0.66 to 2.71; p=0.001). The use of triple elimination decreased by a distance ≥5km (b=-1.36; 95% CI=-2.27 to -0.46; p= 0.003). Community health center had strong contextual effect on the use of triple elimination with ICC= 22.6%.Conclusion: The use of triple elimination increases with age ≥35 years, working outside the home, income by ≥Rp 1,600,000, perceived susceptibility, perceived seriousness, cues to action, attitude, and strong motivation. The use of triple elimination decreases by a distance ≥5km. Community health center has strong contextual effect on the use of triple elimination.Keywords: triple elimination, Health Belief Model, Theory of Planned BehaviorCorrespondence: Prissy Verasita. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: [email protected]. Mobile: +6285879-345269.Journal of Maternal and Child Health (2020), 5(1): 68-78https://doi.org/10.26911/thejmch.2020.05.01.0

Does Secondary Smoking and Posyandu Affect the Risk of Hypertension in Pregnancy? Multilevel Evidence from Magelang, Central Java

Background: Pregnancy hypertension was a complication of pregnancy which became one of the causes of maternal and perinatal morbidity and mortality in the world. This study aimed to determine the effect of individual and contextual factors of integrated health post (posyandu) on hypertension in pregnancy.Subjects and Method: A case control study was conducted in 5 posyandus in Magelang, Central Java, from April to May 2019. A sample of 210 women was selected by simple random sampling. The dependent variable was hypertension in pregnancy. The independent variables were age, parity, nutritional status, family history of hypertension, history of hypertension before pregnancy, history of hormonal contraceptive, and exposure to cigarette smoke. The data were collected by questionnaire and analyzed by a multilevel multiple logistic regression.Results: Hypertension in pregnancy increased with age 35 years old (b= 2.10; 95% CI= 0.16 to 4.04; p= 0.033), parity (b= -3.81; 95% CI = - 6.31 to -1.32; p = 0.003), nutritional status (b= 3.35; 95% CI= 1.36 to 5.33; p= 0.001), family hypertension history (b= 3.35; 95% CI= 1.33 to 5.37; p= 0.001), hypertension history before pregnancy (b= 2.46; 95% CI= 1.1 to 3.81; p 35 years old, parity, nutritional status, family hypertension history, hypertension history before pregnancy, hormonal contraceptive history, and cigarette smoke exposure. Posyandu has negligible contextual effect on hypertension in pregnancy.Keywords: Hypertension, pregnancy, cigarette smoke, multilevel analysisCorrespondence: Erin Rizkiana, Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email: [email protected]. Mobile: 085729883106Journal of Epidemiology and Public Health (2019), 4(3): 247-258https://doi.org/10.26911/jepublichealth.2019.04.03.12

Prevalence and Determinants of Postpartum Depression in Sukoharjo District, Central Java

Background: After delivery of psychological disorder otherwise appropriately and immediately handled may lead to postpartum depression (PPD). PPD has a serious impact on mothers that manifests as lower quality of life and inability to care of themselves, their partner, and infants. There is a lack of studies on PPD in Indonesia. Its prevalence and determinants are not well-understood. This study sought to estimate the prevalence and the determinants of PPD in Sukoharjo, Central Java.Subjects and Method: This was an analytic observational study with a cross-sectional design. The study was conducted at community health centers in Sukoharjo District, Central Java, from November to December 2017. A total sample of 200 postpartum mothers was selected for this study using cluster random sampling, with a community health center as the cluster. The dependent variable was PPD. The independent variables were maternal age, parity, labor complication, maternal education, self-efficacy, family income, coping strategy, unwanted pregnancy, and family support. The data were collected by questionnaire and analyzed by path analysis.Results: PPD prevalence in Sukoharjo, Central Java, was 18.5%. The risk of PPD increased with labor complication (b= 3.14, SE= 0.45, p<0.001), unwanted pregnancy (b= 1.54, SE= 0.45, p<0.001), and low family income (b= -0.05, SE= 0.01, p<0.001). The risk of PPD decreased with age (b= -0.07, SE= 0.03, p= 0.028), stronger self-efficacy (b= -0.55, SE= 0.09, p<0.001), and improved coping strategy (b= -0.56, SE= 0.03, p= 0.064). PPD was indirectly affected by younger age, parity, weaker family support, lower family income, coping strategy, and maternal education.Conclusion: PPD prevalence is 18.5% in Sukoharjo, Central Java. The risk of PPD increases with labor complication, unwanted pregnancy, and low family income, but decreases with age, stronger self-efficacy, and improved coping strategy.Keyword: prevalence, postpartum depression, determinant, path analysisCorrespondence: Ryanwati Putriarsih. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email: [email protected]. Mobile: +6281393085790Journal of Maternal and Child Health (2018), 3(1): 395-408https://doi.org/10.26911/thejmch.2017.03.01.02

Path Analysis on the Factors Affecting Postnatal Depression

Background: Postpartum depression is one of the emotional disorders as a result of failure to accept the psychological adaptation process in women in the postpartum period. There are many factors of postpartum depression. This study aimd to determine factors affecting postpartum depression.Subjects and Method: This was a cross sectional study conducted at 30 villages, in Bantul, Yogyakarta, from February to March 2019. A sample of 210 postaprtum mothers was selected by purposive sampling. The dependent variable was the postpartum depression. The independent variables were age, education, income, ANC visit, number of children, parity, unwanted pregnancy, type of labor, family support, domestic violence, and stress. Postpartum depression was measured by Endinburgh postnatal depression scale. Psychological stress was measured by Kessler psychological distress scale. The other variables were collected by questionnaire. The data was analyzed by path analysis.Results: Postpartum depression was directly and positively affected by type of labor (b = 3.85; 95% CI= 0.16 to 7.54; p = 0.041), stress (b= 3.53; 95% CI= 0.34 to 6.72; p= 0.030), parity (b= 4.01; 95% CI= 0.04 to 7.98; p= 0.048), unwanted pregnancy (b= 9.43; 95% CI= 1.51 to 17.3; p= 0.019). It was directly and negatively affected by number of children (b = -5.05; 95% CI= -10 to -0.02; p = 0.049), family support (b= -3.73; 95% CI= -6.98 to -0.50; p= 0.024), and ANC visit (b = -8.18; 95% CI= -15.3 to -1.00; p= 0.026). Postpartum depression was indirectly affected by education, income, domestic violence, and age.Conclusion: Postpartum depression is directly and positively affected by type of labor, stress, parity, unwanted pregnancy. It is directly and negatively affected by number of children, family support, and ANC visit. Postpartum depression is indirectly affected by education, income, domestic violence, and age.Keywords: Postpartum depression, domestic violence, path analysisCorrespondence: Sri Widarti. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: [email protected]: 082135814923.Journal of Maternal and Child Health (2019), 4(5): 358-368https://doi.org/10.26911/thejmch.2019.04.05.1

Contextual Effect of Community Health Center on Visual Inspection Acetic Acid Uptake in Magelang, Central Java: A Multilevel Analysis

Background: Cervical cancer is a major prob­lem in women's. Cervical cancer can be prevented by early examinations i.e. visual inspection acetic acid (VIA). This study aimed to analyze the contex­tual effect of community health center on VIA up­take in Magelang, Central Java.Subjects and Method: This was analytic obser­­­­vational study with cross-sectional design. The stu­dy was conducted at 25 community health cen­­­­­ters in Magelang, Central Java, from Sep­tem­ber to October 2019. A to­tal sample of 200 women aged 30 to 50 years was selected ran­domly. The dependent variable was VIA uptake. The independent variables were knowledge, ob­ser­­­vational lear­ning, behavioral reinforcement, cues for action, access to information, family sup­port, attitude, self-efficacy, outcome expec­tation, and contextual factor of community health cen­ter. The data were collected by ques­tion­naire and analyzed by a multilevel multiple logistic reg­res­sion run on Stata 13.Results: VIA uptake increased with good know­ledge (b= 4.02; 95% CI= 0.61 to 7.42; p= 0.021), obser­­vational learning (b= 2.28; 95% CI= -0.35 to 4.93; p= 0.090), strong behavioral rein­force­ment (b= 4.11; 95% CI= 0.82 to 7.40; p= 0.014), strong cues to action (b= 5.36; 95% CI= 0.65 to 10.07; p= 0.026), good access to information (b= 3.71; 95% CI= 0.42 to 7.01; p= 0.027), strong family support (b= 4.23; 95% CI= 0.21 to 8.25; p= 0.039), positive attitude (b= 3.29; 95% CI= -0.23 to 6.81; p= 0.067), strong self-efficacy (b= 2.94; 95% CI= 0.10 to 5.78; p= 0.042), and strong outcome expectation (b= 3.39; 95% CI= 0.35 to 6.44; p= 0.029). Community health cen­ter had strong contextual effect on VIA uptake with intra-class correlation (ICC)= 23%.Conclusion: VIA uptake increases with good know­ledge, observational learning, strong beha­vi­o­ral rein­forcement, strong cues to action, good access to information, strong family support, posi­tive attitude, strong self-efficacy, and strong out­come expectation. The community health center has a strong contextual effect on VIA uptake.Keywords: visual inspection acetic acid, social cognitive theory, multilevel analysisCorrespondence: Herlina Ika Martaningrum, Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Su­tami 36A, Surakarta 57126, Central Java, Indo­nesia. Email: [email protected]. Mobile: 085643528156Journal of Maternal and Child Health (2020), 5(2): 129-140https://doi.org/10.26911/thejmch.2020.05.02.02 

Menopause and Biopsychosocial Factors Associated with Quality of Life in Women in Surakarta, Central Java

Background: Women spend a third of life during menopause. The number of women entering menopause worldwide is estimated at 25 million annually. Women of menopausal age have decreased estrogen hormone which can decrease the quality of life. This study aimed to analyze the biopsychosocial factors and menopause affecting the women's quality of life.Subjects and Method: This was an analytic observational study with a cross-sectional design. The study was conducted in Surakarta, from January to February 2018. A sample of 200 women was selected by cluster sampling. The dependent variable was quality of life. The independent variables were self-efficacy, healthy behavior, menopause, and social support. The data were collected by questionnaire and analyzed by path analysis.Results: Womens quality of life increased with healthy behavior (b= 0.96; 95% CI= 0.35 to 1.56; p=0.002) and decreased by menopause (b= -0.96; 95% CI= -1.56 to -0.35; p= 0.002). Womens quality of life was indirectly affected by self-efficacy and social support.Conclusion: Womens quality of life is affected by menopause, healthy behavior, self-efficacy, and social support.Keywords: quality of life, women, biopsychosocial, menopauseCorrespondence:Dwi Hesti Ermawati, Masters Program in Public Health, UniversitasSebelasMaret, Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email: [email protected] of Maternal and Child Health (2018), 3(2): 119-127https://doi.org/10.26911/thejmch.2018.03.02.0

Optimizing the Combination of Oxytocin Massage and Hypnobreastfeeding for Breast Milk Production among Post-Partum Mothers

Background: The incidence of post-partum blues both in Indonesia and abroad has been quite high; the stress that post-partum mothers experience will inhibit breast milk production and, as a result, breastfeeding process should be stopped earlier. Hypnobreastfeeding relaxation and oxytocin massage have been a combination of therapy that might decrease the rate of Adenocorticotropic Hormon (ACTH) and that might assist hormone and prolactin secrection in order that breast milk production becomes fluent. This study then aimed at analyzing the optimization of the combination of oxytocin massage and hypnobreastfeeding in order to decrease anxiety and to improve breast milk production among post-partum mothers.Subjects and Method: This was an analytic experimental study with Randomized Control Trial (RCT) design. This study was conducted at Dr. Suradji Tirtonegoro Central General Hospital, Klaten, from January 25th, 2017 until March 9th, 2017. The population in this study was 200 post-partum mothers. A sample of 60 post-partum mothers was selected for this study and allocated into the intervention group (n1= 30) and the control group (n2= 30). The intervention group would be treated by the combination of oxytocin massage and hypno­breastfeeding. The dependent variables were anxiety and breast milk production. The independent variables were oxytocin massage and hypnobreastfeeding. The anxiety was measured by STAI scale. The breast milk production process was measured by checklist questionnaire. The breast milk production amount was measured by milking cups. The breast milk production between the two groups was tested by Mann-Whitney.Results: The anxiety scale in the intervention group was better and lower than that of the control group. The differences in terms of anxiety scale between the intervention group (median= 24.00; SD= 4.45) and the control group (median= 34.00; SD= 6.93) were statistically significant (p<0.001). Then, the differences in terms of breast milk production process between the inter­vention group (median= 9.00; SD= 1.66) and the control group (median= 8.00; SD= 1.56) were nearly significant (p<0.145). Furthermore, the differences in terms of breast milk production amount between the intervention group (median= 10.00; SD= 10.36) and the control group (median= 4.50; SD= 4.21) were statistically significant (p<0.001).Conclusion: Combination of oxytocin massage and hypnobreastfeeding can effectively decreasing anxiety and increasing breast milk production for post-partum mothers.Keywords: oxytocin massage, hypnobreastfeeding, breast milk production, post-partumCorrespondence: Lutfiana Puspita Sari. Masters Program in Public Health, Sebelas Maret University, Surakarta. ­­Email: [email protected]. Mobile: +6282221522374.Journal of Maternal and Child Health (2017), 1(1): 20-29https://doi.org/10.26911/thejmch.2017.02.01.0